The Medical Board of California approved an amendment to California administrative law that would allow physicians assistants (PA) to perform surgery without the immediate physical presence of a supervising physician.

Existing law permits PAs to act as first or second assistant in surgery under the supervision of a physician. In 2011, a concern was raised by a PA licensee to the Physician Assistant Board that the current regulation did not reflect current medical community standards and that the law was unclear on the degree of physician supervision required of a PA as an assistant in surgery.

The final regulation, which goes into effect on April 1, 2015, clarifies that a PA may perform surgical procedures, without the physical presence of the supervising physician in the operating room if the physician is "immediately available" to the PA. The medical board defines “immediately available" as “able to return to the patient without delay, upon the request of the PA or to address any situation requiring the supervising physician’s services.”

During the course of the regulatory discussions, it was agreed that an update to the regulation to specify the degree of supervision required for the PA was necessary in light of the evolution of current medical practices for both professions. Under the new regulation, physicians could, for example, direct a PA to close the surgical site, allowing the physician to engage in other procedures or tasks on site.

For more information on physician assistants, see CMA On-Call document #3007, “Physician Assistants.” This document, as well as the rest of the California Medical Association's (CMA) online health law library, is available free to members in CMA's CMA Store. Nonmembers can purchase documents for $2 per page.

Contact: Yvonne Choong, (916) 551-2884 or ychoong@cmadocs.org.